HX641 60955 
RM811  .B81  Notes  on  hydrotherap 


RECAP 


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NOTES  ON  HYDROTHERAPY. 


There  is  no  other  remedy  which  so  much  requires  a  correct  appli- 
cation as  does  water,  It  is  for  this  verj'  reason  that  it  lias  eometimes 
grown  into  disfavor  among-  physicians,  because  of  its  being  applied 
in  a  haphazard  way  by  lay  persons,  who,  having  seen  remarkable 
effects  produced  by  it,  and  who,  being  guided  by  their  ignorance 
rather  than  by  any  knowledge  of  the  subject,  imagine  they  can 
achieve  the  same  results. 

The  proper  use  of  water  is  based  on  a  correct  knowledge  of  jihys- 
iology  and  upon  how  the  forces  involved  in  its  use  act  upon  the 
human  body. 

It  is  necessary  that  the  profession  should  adopt  Hydrotherapy  as 
an  integral  and  useful  portion  of  therapeutics.  Its  uses  should  l)e 
understood,  as  well  as  its  principles. 

External  stimuli  aie  heat  and  cold,  mechanical  impression,  elec- 
tricity and  chemical  substances. 

The  stimuli  applied  in  the  use  of  baths  and  douches  are  thermal, 
mechanical  and  chemical ;  the  mechanical  being  the  friction  employ- 
ed in  conjunction  with  the  application  of  the  water  and  the  impact  of 
the  water  ;  tlie  chemical,  jtrineipally  the  salts  which  are  added  to  tlie 
water. 

This  stimulation  produces  diverse  changes  in  the  animal  economy. 

Saturation  of  the  nerve  endings  with  moisture,  brought  about  by 
the  absorption  of  water  by  the  skin,  or  by  the  prevention  of  water 
being  given  off  from  the  skin,  produces  a  quieting  effect  on  the 
nervous  system. 

Water  also  acts  by  adding  or  subtracting  heat. 

The  tendency  of  modern  therapeutics  is  to  limit  the  use  of  drugs 
and  to  make  more  use  of  natural  methods.  The  principle  involved  is 
sound.  The  action  of  drugs  is  followed  in  many  instances  by  a  harm- 
ful reaction:  natural  remedies  acting  in  a  physiological  way,  do 
not,  when  properly  applied,  produce  such  a  harmful  reaction,  and 
are  in  this  respect  superior. 

For  the  giving  of  douches,  special  apparatus  is  necessary  for  regu- 

3 


liitiiiu'  tciii|icraliir('  and  |iicssiirc,  and  lln'  hoi  icsiills  arc  ohlaiiicd  liy 
Irairird  atlciidaiils  ;  luil  almvr  all  canlul  MiiMT\i>i<>ii  nf  baths  is  rr- 
i|iiiiiil  llial  tlir\  may  he  adapted  to  tlic  |i(culiar  needs  of  each 
|iat  lent  . 

'I'herc  arc  certain  indications  lor  the  i^ivini;-  (d'  s])eeial  forms  (d' 
liaths.  liiit  the  reactive  caixicity  id'  cacdi  patient  must  he  learned ,  and 
this  ol'lcn  can  ho  obtained  in  no  other  way  tliiin  hy  tlie  aijplication 
of  water. 

l'\ir  the  purpose  of  ac((uirini;'  knowleduc  as  to  the  rcaeti\'c  capacity 
of  the  patient  it  is  often  necessary  or  expedient  to  Ix'nin  liydro- 
therapeutie  treatment  by  rt  siw^jZc  ahUition  or  loashing.  Tins  al)lu- 
lion  or  wasiiinji-,  by  lowering  tlie  tenii)erature  of  the  water  each  time 
it  is  given,  may  also  be  used  to  train  tlie  reactive  power  of  the 
patient. 

A  general  ablution  is  a  procedure  wliich  may  he  next  tried. 
From  the  latter  to  half-hath,  or  met-nheet  rulj  and  (loncliea  is  a  short 
step.  These  latter  procedures  may  be  varied  to  suit  tlie  individual 
needs  of  each  patient.  The  tem])(Mat ure,  the  duration  and  the 
mechaincal  factor,  the  rul)l)ing  or  tlu^  |>ressure  under  which  the 
douche  is  applied  may  be  very  different  for  the  same  procedure. 

At  the  I'lnversity  of  Vienna,  a  full  chair  is  given  to  IIydrothera])y  , 
which  Prof.  Winternitz  has  held  for  40  years,  and  his  endeavor  has 
been  to  rescue  Hydrot herajiy  from  cmjiiricism,  and  to  place  it  upon 
a  rational  physiological  basis. 

l>aru(di  in  this  country,  has  done  good  work.  Hishydriatie  insti- 
tute in  New  York,  affords  the  ]irofession  of  that  c-ity  the  o])])orl  unity 
for  having  an  exact  hydrothcrapeut  ic  iireserijition  rilled.  The 
Orthopedic  and  German  Hospitals  in  Philadelphia  have  the  means 
of  giving  different  sorts  of  baths  and  douches.  Boston  for  the 
last  four  years,  has  had  an  establi.shment  under  the  able  management 
of  Doctor  Joseph  H.  Piatt.,  where  hydriatic  preserijjtions  of  all  sorts 
tan  be  larricd  out.  The  (Shepherd  and  Enoch  Pratt  llosj'ifal  at 
Towson  lia.>  now  a  comiilete  hydrothe]i)]ieuti(  plant,  and  Dm  tor 
Brush  in  his  last  report,  says  it  is  accomplishing  much  good. 

All  physicians  recognize  that  there  are  certain  classes  of  eases  fc^r 
which  Hydrotherapy  is  suited.     The  ditheulty    has  been    that    there 
has  been  no  means  at  hand  to  apply  this  treatment. 
St.  Agues'  Hospital  is  now  able  to  supply  this  need.     Physicians 


may  scud  their  patients  ttierc  to  receive  hydrotherapcutic  ti-eat incut, 
witiiout  Ibeir  rcmaiiiiuii'  in  the  liospilal. 

There  are  a  number  of  l)atlis,  the  forms  of  which  iiavc  l)ccomc 
classical.  As  they  are  given  here,  Winteruit/'  and  Baruch's  textbooks 
on  Hj'drotherapy  are  followed.  The  directions  for  the  Naiiheim 
Bath  are  taken  from  the  article  by  C.  N.  B.  Camac,  M.  D.,  in  the 
Johns  Iloiikiiis'  r.nnetin  for  :\ray,  1897. 


ABbUTlON  OR    WASHING- 
Rkqtisttes. 

Severtd  vessels  containing-  water. 

1.   Containing  water  80-50°,  temperature  prescribed,  for  face. 

1.  Containing  water,  temperature  prescribed,  for  body. 

1.  Containing   water  5°    lower   than   temperature     ])rescribed    for 
body,  for  cooling  towels  used. 

Towels  for  wet  rubbing  and  for  drying  patient. 

Method. — Dry  pack  previously  or  not. 

Wash  patient's  face  beforehand,  gradually  decreasing  the  tem- 
perature each  time.     Have  special  vessel  for  this  purpose. 

Have  at  least  two  vessels-  of  water,  one  5°  cooler  than  that 
prescril)ed.  The  cloths  or  towels  to  be  placed  in  the  cooler  water 
when  taken  from  the  patient. 

Part  by  part  is  uncovered,  washed,  dried  and  covered  up  again . 
One  can  thus  cool  each  part  more  or  less,  or  stimulate  more  or  less 
energetically  by  rubbing. 

A  certain  order  should  l)e  followed,  namely: — arms,  chest,  ab- 
domen, back,  and  legs. 

The  washing  must  be  done  rapidly,  wrapping  the  pait  in  a  wet 
cloth  or  towel  and  rubbing;  then  either  wrapping  in  a  dry  cloth, 
or  wlien  the  part  is  very  warm,  again  applying  a  wet  cloth  and  rub- 
bing.    One  must  always  end  by  drying  and  more  or  less  rubbing. 


GENERAL    ABLUTION- 
The  patient  stands  in  12  in.   of   water  at   95-100°,    and  is  rapidly 
waslied  down  with  the  hands,  having  water   at   50''-80°,  according  to 
prescription,  poured  upon   him  with   the   hand,  or   from   a   vessel, 
accompanied  by  gentle  friction.     Dry  according  to  directions. 

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HALiF    BATH- 

RlitiUISITES  : 

Cap  or  towel  lor  licad  . 

Sniiill  vossols  lor  llirowiiii;  water. 

Till)  contaiiiiiiij  (')   to    8    iiiclics    of   water    of    temjx'ralnre    i»re- 

seribed. 
Sheet  or  two  lavfic  towels  for  dryinii. 

Six  to  eight  incJies  of  water  are  drawn  in  a  tul).  liaving  tlie  tem- 
perature prescribed . 

The  head  and  face  are  batlied  with  water,  and  a  wet  cap  is  i)laeed 
upon  or  a  wet  towel  around  tlie  head. 

The  patient  is  then  placed  in  the  tul),  and  by  means  of  a  small 
vessel,  the  nurse,  standing  behind  the  patient,  throws  the  water  over 
the  patient's  back  and  neck,  and  even  upon  the  head,  when  the 
nervous  centers  are  affected,  e.  g.,  in  delirium,  somnolenee,  coma. 
At  the  same  time  the  nurse  rubs  the  shoulders  and  back. 

While  tliis  is  going  on,  the  patient  is  usually  told  lo  rub  the  lower 
limbs,  and  to  rub  and  tlirow  the  water  upon  the  front  part  of  the 
l)ody.  If  the  patient  is  not  able  to  do  this,  a  second  nurse 
must  do  it. 

After  a  short  time  the  patient  can  take  a  recumbent  position  in  the 
tub,  or  when  very  weak  can  take  this  position  from  the  beginning  of 
the  bath. 

The  pouring  of  the  water  is  now  stopped  or  confined  to  the  front 
part  of  the  body.  The  nurse  now  rubs  the  whole  body  vigorously 
under  water.  The  patient  again  sits  up,  and  the  water  is  again 
jioured  upon  the  head,  neck  and  back,  the  back  and  slioulders  being 
rubbed  at  the  same  time.  This  routine  is  repeated  as  many  times  as 
is  neces.sary  to  consume  the  length  of  tune  that  is  prescrilted  for  the 
bath. 

Remove  the  patient  from  the  tub.  Wrap  in  a  sheet  or  towels 
and  dry  l)y  rubbing.  If  tlie  towels  are  used,  put  one  around  the 
trunk  and  upper  extremities,  and  the  second  around  tlie  lower  ex- 
tremities. 

If  the  i)atient  is  too  weak  to  stand,  put  to  bed  at  once,  and  dry  in 
bed  b}'  rubbing. 

From  the  time  of  Priestnitz,  this  bath,  in  acute  and  chronic  diseases, 
has  been  modified  in  this  way,  that  during  the  time  of  the   ])ath,   the 

6 


temperature  is  lowered  soinewliat   ))y  the  adilitioii    in'    ruiiniiiu'   in    of 
cold  water. 

This  batli  is  in  some  ways  similar  to  the  form  of  the  l)ath  to    whieli 
the  name  of  Siemsson  is  applied. 


WET-SHEET   F^UB. 

REQri8ITES  : 

Sheet  two  by  three  yards. 
Wet  cap  or  towel  for  head. 
Dr}'  towels. 
Water  temjierature  ])rcserihed. 

Method.— The  whole  bath  should  be  given  quicklj^  A  linen  sheet, 
a  cotton  one  will  do  if  you  cannot  get  a  linen  one  :  an  old  table  cloth 
without  patches  is  better  than  a  cotton  sheet.  The  sheet  should 
generally  be  two  yards  wide  by  two  and  a  half  to  three  yards  long  :  a 
very  large  person  requires  three  yards,  and  if  the  person  i.s  short  of  sta- 
ture a  yard  and  a  half  will  do  for  the  width ,  but  for  ordinary  purposes, 
three  yards  by  two  yards  are  the  proper  dimensions. 

Shake  out  the  sheet  and  pleat  on  the  long  dimension,  and  then  fold 
and  dip  in  water  of  the  temperature  indicated,  and  wring  out  more 
or  less.  If  you  wish  to  reduce  temperature  you  would  not  wring  it 
out  so  much  as  when  j'ou  do  not  have  this  indication  to  meet. 

The  patient's  face  should  have  previously  been  w^ashed,  and  a  wet 
cap  put  on  the  head,  or  where  the  hair  is  long,  a  wet  towel  bound 
around  the  forehead.  This  is  a  necessary'  precaution  to  j)revent  too 
great  a  flow  of  blood  to  the  head. 

The  sheet  is  applied  in  the  following  manner :  The  nurse  stands  at 
the  right  side  of  the  patient  and  holds  the  folds  of  the  sheet  in  the 
right  hand.  It  Is  applied  first,  under  the  right  arm,  then  across  the 
chest,  under  the  left  arm,  across  the  back,  over  the  right  shoulder, 
across  the  chest,  over  the  left  shoulder  and  tucked  in  about  the 
neck.  It  is  shoved  in  between  the  knees  and  the  patient  is  then 
rubbed  down,  the  hand  passing  over  the  sheet,  till  the  sheet  feels 
equally  warm  all  over.     TIte  ruhbiny  should  he  done  in  long  irtpid  strokes. 

Remove  the  sheet  and  drv  thorouirhlv  with  towels. 


ABLUTION    IN    FEVER   CASES. 

(/llijirii/icfli/  nillcd  sj)(>l/i/c  hdlli.) 
l{i;(,irisiTKs  : 

Sc\cr;il  l)iisiiis.     OiuMiirue.     ( )iu' siunll. 

Jiatli  glove  or  linen  wiisli-clol  li.     Two. 

liubhcr  shed . 

i'.Mlil  I'.liiiikct. 

I  j'licli  slicci  . 

Water  of  proper  temperatures. 
This  hatii  consists  in  the  Jipplication  of  water  by  the  hand,  or  cov- 
ered !)y  a  batli  glove,  or  holding  a  linen  wash-eloth. 

The  sponge  is  to  be  avoided,  because  it  does  not  produce  sutlieient 
friction  and  discourages  reaction. 

jNIkthod. — Several  vessels  with  water  of  the  proper  temperature 
must  be  within  reach.  In  acute  febrile  affections  with  temperatures 
above  101°,  an  oil  cloth  or  rubber  sheet  is  laid  upon  one  side  of  the  bed, 
covered  by  a  blanket,  and  upon  this  a  linen  sheet  or  table  cloth,  one  half 
reaching  over  the  edge  of  the  bed  (I  think  an  ordinary  cotton  sheet 
as  good).  The  jiatient  is  now  placed  upon  the  sheet,  his  face  is  bathed 
with  water  from  60°-70°,  beginning  with  the  higher  temperature,  and 
on  each  application  reducing  it  two  or  more  degrees. 

The  chest  and  arms,  the  back,  abdomen  and  lower  extremities  are 
successively  l)athed  by  freely  applying  water.  This  is  far  superior  to 
sponging,  which  chills  by  evajioration,  while  the  gentle  shock  of  the 
impact  of  the  water  applied  in  this  way,  accompanied  and  followed 
by  gentle  friction,  arouses  the  peripheral  nerves,  and  thus  stimulates 
the  entire  system  by  its  retlex  agency. 

Another  method  for  enhancing  the  antifebrile  effect,  is  tlie  placing 
of  wet  linen  towels  (always  without  fringe),  successively  over  the 
chest,  abdomen,  back  and  upper  extremities,  followed  by  gentle  fric- 
tion and  patting  over  the  towel. 


TH1R0AT   BANDAGE. 

Although  this  compress  is  probably  more  frecjuently  applied  than 
any  other,  it  is  remarkable  how  little  its  rationale  is  understood 
and  how  imperfectly  it  is  applied. 

When  intended  for  the  treatment  of  tonsillitis,  and  other  pharingial 

8 


art'ectioiis,  tlie  tlirout  coiupress  should  be  applied  as  follows: 

Method. — A  piece  of  old  linen,  of  sufficient  length  to  reach  from 
below  the  ear  on  the  one  side  to  the  same  point  on  the  left,  is  folded 
into  a  banda,2:e  of  four  layers.  A  piece  of  flannel,  eight  bj'^  twenty- 
four  inches,  provided  with  a  slit  for  each  ear,  is  also  made  readj^. 
These  bandages  are  fitted  by  actual  measurement  to  the  patient's 
head,  so  they  may  pass  under  the  chin  from  ear  to  ear. 

The  linen  compress  bandage  is  now  wrung  out  of  water  60°,  and  laid 
upon  the  middle  of  the  dry  flannel  bandage.  While  the  wet  bandage 
is  placed  under  the  chin,  the  flannel  bandage  is  unrolled  from  the 
top  of  the  head  (the  right  ear  being  made  to  protrude  through  the 
slit),  and  then  passed  under  the  chin  to  the  left  side,  where  the  left 
ear  is  allowed  to  protrude  (the  slit  being  longer  than  is  actually  need- 
ed, to  insure  perfect  apposition  of  the  bandage  and  prevent  pressure 
on  the  ear).  The  entire  bandage  is  now  drawn  over  the  head  and 
secured  bv  pins. 

Two  sets  of  bandages  are  required , — one  being  allowed  to  dry  while 
the  other  is  in  use. 

In  children  and  restless  patients,  additional  security  is  afforded  by  a 
circular  turn  around  the  head,  forming  a  bandage  to  which  the 
throat  compress  may  be  pinned. 


Is^AUHElM    BATH- 

The  course  consists  of  six  baths,  the  first  and  second  being  simply 
Avith  salts,  calcium  chloride  and  sodium  chloride:  the   third,    fourth, 
flfth  and  sixth  contain  carbonic  acid  as  well  as  these  salts. 
Bath  No.  1.— Sod.  Chlor.    4  lbs.,     Calcium  Chloride    6  oz. 
"         2. — Sod.  Chlor.    5    "         Calcium  Chloride     8    " 
3.— Sod.  Chlor.     6    "         Calcium  Chloride  10    " 
"  Sod.  Bicarb.  6   oz.,     Hydrochlor.    acid     7    " 

4.— Sod.  Chlor.     7  lbs.,     Calcium  Chloride  10    " 
"  Sod.   Bicarb.  8    oz.,     Hydrochlor.   acid  12    " 

5.— Sod.  Chlor.     9  lbs.,     Calcium  Chloride  11    " 
"  Sod.  Bicarb.  1    lb.,     Hydrochlor.   acid     1    lb. 

6.— Sod.  Chlor.  11  lbs.,     Calcium  Chloride  12  oz. 
"  Sod.  Bicarb.  1    lb.,     Hydrochlor.   acid    2  lbs. 

Each  bath  consists  of  40  gallons  of  water. 
9 


Tlie  (liri'clioiis  to  iiui'scs  in  giving- lial  lis  arc: 

1. — Understand  I'roin  the  doctor  tlic  following  jtoiiits: 
A .     Streugtli  of  bath  to  be  given. 
]'..     Temperature  of  1)atli. 

c.      Length  of  time  tiie  patient  is  to  remain  in  the  bath. 
Note:— Give  the  bath  in  the  morning  unless  ol  herwisc  oidcrcd. 
3. — Attend  to  the  following  points  carefully: 

A.  Give  bath  on  an  empty  stomach. 

B.  Note  time  from  the   moment  pati(^nt  is  immersed  to  that 

when  he  is  taken  out. 
c.     Allow  the  patient  to  make  as  little  exertion  as  possible; 

assist  him  in  every  way. 
]).     A  sheet  may  be  drawn  over  the  tub,  but  not  around  the 

patient. 
E.     Be  sure  the  entire  body  is  immersed. 

V.     Keep   the  finger  on  tlie  i)ulsc  the  entire  time  the  jiatient 
is  in  the  bath. 
Danger  signals:— 

Cyanois  (bluing  of  the  face). 
Dyspnoea  (difficult  breathing). 
Apnoea  (gasping). 
Inappreciable  pulse. 
On  the  appearance  of  any  of  these  symi)toms  take  the  patient  out 
of  the  bath  immediately,   put  him  to  bed  and  keep  him  as  (juiet  as 
possible. 

Friction  while  in  the  bath  is  not  necessary,  ])ut  if  the  fingers  and 
toes  become  ])luish,  the  extremities  may  be  rubbed  slightly  towards 
the  trunk.  Friction  should  be  cautiously  employed ;  when  the 
patient  is  out  of  the  tub,  rub  him  to  a  glow;  give  him  a  glass  of  milk 
or  a  cup  of  bouillon  and  allow  him  to  rest  for  an  hour. 

Dr.  Schott  says: — "The  method  of  administering  the  baths  is  of 
the  greatest  importance.  It  is  advisable  to  begin  with  a  1  per  cent, 
salt  bath  containing  one  ouetliousandth  of  Chloride  of  Calcium,  freed 
from  gas  and  at  a  temperature  varying  from  92°-95°  F.,  the  bath  last- 
iuo-  from  6  to  8  minutes.  The  course  of  treatment  should  be  interrup- 
ted by  frequent  intervals  of  one  day.  The  temperature  of  the  bath 
should,  if  possible,  be  gradually  lowered,  while  the  proportion  of 
solids  in  solution  and  the  duration  of  the  bath  are  gradually  increased . 
At  a  latter  stage  it  is  permissible  to  proceed  to  baths  containing  car- 
bonic acid.     The  temperature  may  then  be  rapidly  lowered." 

1(1 


Examples  of  presoriptious  which  may  l)e  uivcn: 
Dry  pack  until  skin  is  warm  aud  cutaneous  vessels  dilated. 
Wet  mitt  friction,  usino;  water  60°. 

Repeat  daily,    reducing    tcmjicrature   of  water  2°    each  treatment , 
until  40°  is  reached. — Kell'xjg. 


Dry  pack  until  skin  is  warm. 
Cold  towel  rub;  temperature  of  water  60°. 

Repeat  daily,  lowering  temperature  of  water  1°    eacli  treatment, 
until   40°  is  reached. — Kellogg. 


Hot  air  cabinet  nearly  to  point  of  perspiration. 
Wet  sheet  rub;  temperature  of  water  70°. 

Repeat  daily,  lowering  temperature   of   water    1°    each  day    until 
60°  is  reached.— Pro </. 


Hot  air  cabinet  to  point  of  perspiration. 
Half  bath;  temperature   of  water  70°  ;  duration  one  minute. 
Repeat  daily,  lowering  temperature  gradually  to  60°  and  increasing 
len«rth  of  bath  to  three  minutes.  — P/v?//'. 


Hot  air  cabinet  to  point  of  perspiration. 

Circular  douche  105°-110°-90°,  two  minutes. 

Fan  and  jet  douche  to  entire  body  90°-S0°,  pressure  10  [lounds, 
one  minute. 

Lower  minimum  temperature  2°,  aud  increase  pressure  2  pounds 
each  treatment,  until  a  temperature  of  60°  and  a  pressure  of  30 
pounds  are  used. — Pratt. 


Hot  air  cabinet  to  perspiration. 

Circular  douche  95°-80°,  thirty  seconds. 

Spray  douche  70°,  30  pounds,  tive  seconds. 

General  massage  ten  minutes. 

Reduce  temperature  of  spray  douclie  1°  daWy. —  Baruch. 

11 


lldt  air  cithitict,  lirtccii  to  I  wciily  li  vf  inimitcs. 

(Mrciilar  (louche,  105°-110°-90",  two  ininules. 

Jet  aud  fan  douche,  90°-85°,  oue  minute,  pressure  10  pounds. 

Repeat  two  or  three  times  weekly,  increasini>'  ])ressure  2  pounds 
and  rediicinu-  terniinal  temperature  2°  each  treatment  until  pressure 
of  ;{0  pounds  and  temperature  of  00°  are  reached. —  Prdtt. 

Hot  aircaliinet,  fifteen  to  twenty  live  minutes. 

Dry  jiaek,  thirty  minutes.     Rest  in  bed  one  hour. — Matthes. 


Baking  machine  to  affected  joint,  temperature  90°  C,  one  liour. 
Spray  douche  70°,  15  pounds  pressure,  ten  seconds. 
Repeat  daily,  increasing  temperature  of  local  hot  air  ])ath  2°  daily 
until  temperature  of  130°  is  reached. — Pratt . 


Hot  air  ca1)inet  to  point  of  perspiration. 

Circular  douche  105°-90°,  two  minutes. 

Rain  douclie  86°-80°,  forty  seconds,  pressure  10  pounds. 

Oil  rul). 

Reduce  final  temperature  of  rain  douch  1°  and  increase  pressure 
1  pound  until  temperature  of  60°  and  pressure  of  20  pounds  are 
reached. — Pratt . 


Hot  air  cabinet  to  point  of  perspiration. 

Circular  douche  105°-110°-100°,  two  minutes. 

Spray  and  jet  douche  to  entire  body,  pressure  15  pounds,  70°, 
twenty  seconds. 

Repeat  daily,  raising  pressure  2  pounds,  and  reducing,  temperature 
of  cold  douche  2°  each  treatment  until  pressure  of  35  pounds,  and 
temperature  of  60°  are  reached. — Pratt. 


Hot  air  cabinet  to  perspiration. 
Circular  douche  105°-95°,  two  minutes. 
Jet  douche  to  abdomen  75°,  thirty  seconds. 

Spray  douche  to  entire  body,  75°,  ten  seconds,  pre.ssure  of  12  poiinds, 
Abdominal  massage. 

Repeat  daily,  increasing  pressure   1    pound  and  lowering  temper- 
ature 1°  each  application  until 25  pounds  and60°are  reached. — Pratt. 

12 


Hot  air  cabinet  to  perspiration. 

Circular  douclie  105°  95 ""^  one  minute. 

Jet  douclie  to  alxlonicii,  10  pounds,  80°  raised  irradually  to  120°, 
lifteen  to  ten  nunutes. 

Fan  douche  to  abdomen,  tlien  to  (k)rsal  region,  lo  pounds,  60°, 
tifteen  seconds. 

General  jet  douclie,  70°,  five  seconds. 

Kepeat  daily  for  gastralgia. — Beni-Barde. 


Hot  air  cabinet  almost  to  perspiration. 

Circular  douche  105°-95°,  one  minute. 

Small  jet  douche  to  course  of  colon,  alternate  60°  and  115°,  tifteen 
seconds  each,  pressure  15  pounds,  one  or  two  minutes. 

Fan  douche  to  chest  and  back  75°,  ten  seconds. 

liepeat  daily  for  constipation,  increasing  2  pounds  each  treatment, 
until  20  pounds  are  used.^ — Pratt. 

Hot  air  cabincl  unlil  cutaneous  vessels  arc  ililated. 
Wet  sheet  rul). 

Sitz-bath,  temperature  70°,  ten  minutes. 
Simultaneous  hot    foot  bath,  temperature  110°. 
Repeat  daily,  increasing  duration  gradually  to  twenty  minutes  and 
lowering  temperature  to  50°. — Pratt . 

Hot  air  cabinet  to  perspiration. 
Circular  douche  105°-U5°,  one  minute. 

Ascending  douche  60--T0',  two  to  three  minute;,  5-10  pounds 
pressure. 

Rain  douche  105°,  thirty  seconds. 

Fan  douche  to  entire  1)ody,  ten  seconds.  15  pounds,  70°. — Pratt. 

Hot  air  cabinet  lo  point  of  peis])iratiou. 

Circular  douche  lOS'-OO",  two  minutes. 

Jet  and  fan  douche  90°-85°,  15  pounds,  one  minute. 

Jet  douche  to  spine  75°,  fifteen  seconds. 

Lower  minimum  temperature  2°,  and  increase  pressure  1  pound 
each  application  until  pressure  of  35  pounds  and  temperature  of  50° 
are  reached. — Pratt. 

13 


Hot  air  cal)iiict  until  ciitaiicous  vessels  are  dilated.  Remove  be- 
fore perspiration  ])egins. 

Circular  douche  95°-85°,  one  half  to  one  minute. 

General  fan  douche  80°,  20  jiounds,  ten  to  twenty  seconds.  Dry 
rapidly. 

Walk  in   the  open  air  until  somewhat   fatigued. 

Kepeat  daily,  reducing  minimum  temperature  1°  each  treatment. 

Once  during  week  allow  i)atient  to  pcrsjtire  five  minutes  in  cal)- 
inet. — Bariich. 


Hot   air  cahinet   almost  to  point   i»f  perspiration. 
Circular  douclie  95°-85°,  one  half  to  one  minute. 
Fan  douche  to  back,  75°,  30  pounds,  live  seconds. 
General  fan  douche  78°,  30  pounds,  fifteen  seconds. 
After  several  days,  substitute  jet  douche  for  fan  douche  to  back, 
lower  temperature  of  general  fan  douche  1°    daily. — Barvrh. 


Hot  air  cal)inet  to  beginning  perspiration. 
Circular  douche  25  pounds,  95°-80°,  one  minute. 
Jet  douche  to  back,  30  pounds,  75°,  live  seconds,  daily    reduced 
1°. 

Friction.     Walk  in  open   air. — Baruch. 

Hot  air  cal)inet   to  beginning  perspiration. 
Circular  douche  10  pounds,  105° -92'',  three  minutes. 
General  fan  douche,  10  pounds,  85°,  fifteen  seconds. 
Walk  slowly  in  the  open  air. 

Repeat  daily,  increasing  pressure  and  lowering  temperature    un- 
til 15  pounds  and  80°    are  reached.— /•/•«/<. 

Hot  air  cabinet  to  point  of  perspiration. 
Change  cold  compresses  to  head  frequently. 
Circular  douche  100°-90°,  two   minutes. 
Scotch  or  alternate  jet  douche  to  legs  and  feet,  15  pounds. 
Repeat  daily,  increasing  pressure  1  pound  each  application,  until 
80  pounds  are  borne. — Pratt. 

14 


>^rrf^ 


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